Medium-long-term mortality and change in functional status in elderly patients with pacemaker

Area of Science:

• Cardiology
• Geriatric Medicine
• Biomedical Engineering

Background:

• The majority of pacemaker patients (49%) are now over 80 years old.
• Outcomes regarding mortality and functional status changes after pacemaker implantation in the elderly are not well-documented.

Purpose of the Study:

• To prospectively analyze cardiovascular mortality and changes in functional status in elderly patients after pacemaker implantation.
• To investigate the association between pacemaker systems and medium-long-term outcomes in patients over 70.

Main Methods:

• Observational study of pacemaker implants in individuals over 70 years old (2012-2014).
• Analysis of associations between pacemaker system type, mortality, and functional status.
• Follow-up to assess medium-long-term outcomes.

Main Results:

• 60% of patients were over 80; common indications included third-degree atrioventricular blockage and atrial fibrillation with slow ventricular response.
• Bicameral DDD pacing was most common, though VVI was used in 38.7% of octogenarians.
• Long-term mortality was significantly higher with ventricular devices (VVI) (p=0.001), which were independent predictors of all-cause mortality.
• No significant improvement in Barthel Index or functional status was observed three years post-pacing.

Conclusions:

• Pacemaker implantation in patients over 80 is associated with significantly higher long-term mortality compared to the general population, especially with ventricular devices.
• Single-chamber VVI pacing is an independent predictor of mortality in this elderly cohort.
• No significant functional status improvement was detected in elderly patients three years after pacemaker implantation.